What Your Doctor Won’t Tell You About Your Menopause Symptoms (But You NEED to Know!)

Breaking the Silence Around Menopause

Tamsen opens by highlighting the persistent silence surrounding menopause. Despite over half the population enduring this transition, women rarely discuss it openly at home, in schools, or even during medical appointments. She attributes this to deep-rooted ageism and sexism that society and the healthcare system harbor, essentially signaling that a woman's value declines sharply after her reproductive years. This dismissive attitude has resulted in almost a cultural and medical "goodbye" to women once they reach midlife, framing menopause as a subject to avoid rather than understand.

Reflecting on her career spanning three decades in journalism, Tamsen shares her surprise at never having heard the word "menopause" used openly on television or in health discussions. It was only after receiving a brief diagnosis from her doctor—with no guidance—that she realized the vast lack of information available to women. This lack of awareness extends to doctors themselves, many of whom receive minimal training about menopause symptoms, leading to a staggering 75% of women leaving medical appointments with untreated symptoms.

Understanding Perimenopause and Menopause

Tamsen breaks down the stages of menopause to clarify confusion. Perimenopause is the period leading up to menopause, lasting anywhere from four to ten years, characterized by fluctuating hormones and a variety of physical and emotional symptoms. Menopause itself is officially reached when a woman has gone 12 months without a period. Postmenopause refers to the years following menopause, during which some symptoms may continue.

Perimenopause often begins in women's late 30s or early 40s, a fact many are unaware of, leading to misdiagnosis or dismissal of symptoms as mere stress or aging. Women in perimenopause can still conceive, making this transition even more complex, especially as many women today have children later in life. Symptoms can overlap with postpartum or other life stresses, muddling the picture further.

The Wide Array of Symptoms and Their Real Impact

Contrary to popular belief, menopause symptoms extend far beyond hot flashes and night sweats. Tamsen explains that brain fog often ranks as the most debilitating symptom, affecting memory, concentration, and overall cognitive function. Women describe experiences such as forgetting plotlines in books or losing train of thought mid-conversation. This cognitive confusion can provoke anxiety about serious neurological conditions like dementia or Alzheimer's, yet what women really face is a hormonal rollercoaster as estrogen and progesterone sharply decline.

Physically, women experience joint pain, itchy and dry skin, significant weight gain (especially around the abdomen), sleep disruption, and low libido. Emotionally, mood swings, anxiety, irritability, and sometimes depression are common but rarely acknowledged. The severity and combination of symptoms vary widely among women, making the transition unpredictable and isolating.

The consequences reach beyond the individual, affecting careers, relationships, and family dynamics. Women often find themselves at the peak of their professional lives when perimenopause hits but struggle with productivity and communication challenges due to symptoms. Tamsen stresses the risk of these struggles being misunderstood or penalized in the workplace, calling for greater awareness and supportive policies to retain midlife women, who possess invaluable wisdom and experience.

In relationships, menopause's influence can be profound. The drop in libido and physical discomfort during sex, such as vaginal dryness and pain, often leads to misunderstandings with partners. Couples may misinterpret these changes as loss of attraction or emotional withdrawal, sometimes contributing to splits or divorces in the 40s—a pattern Tamsen believes is closely linked to unaddressed menopausal challenges.

Myths and Misconceptions About Menopause

One pervasive myth Tamsen confronts is the belief that a woman's best years are behind her once she reaches menopause. She counters this by highlighting scientific data and real-life experiences showing many women embrace their postmenopausal years as times of empowerment, clarity, and renewed purpose. Another damaging misconception is labeling women's symptoms as "crazy" or attributing mood swings to personality flaws or stress instead of underlying biological changes. Such stigmatizing language adds to women's feelings of isolation and shame.

Tamsen also challenges the notion that lifestyle alone can fend off menopause symptoms. Many women are taught that eating perfectly and exercising thoroughly will prevent or eliminate symptoms—but the hormonal shifts are unmatched by behavior alone. While lifestyle factors can manage symptoms and support overall health, they cannot cure or reverse the transition.

The Biological and Chemical Changes

From a biochemical standpoint, menopause is primarily driven by a substantial decrease in estrogen and progesterone. Because estrogen receptors exist throughout the body—including the brain—a loss of estrogen impacts many systems. Hormonal fluctuations resemble the tumultuous hormonal changes of puberty but occur at a midlife stage and signify the end of reproductive capacity.

Tamsen reveals her personal challenges with brain fog and cardiorespiratory symptoms like palpitations, which prompted her to seek extensive testing. The confusion and fear these symptoms invoke underscore the need for better understanding and normalization of menopausal changes.

Why the Medical System Fails Women

An alarming reality shared in the conversation is that only about 2% of medical research funding goes to women's health, and an even smaller fraction focuses on menopause and perimenopause. Many doctors receive only a brief introduction to menopause during their training and often fail to recognize or treat symptoms effectively.

This deficit results in women being misdiagnosed or dismissed, sometimes being prescribed antidepressants without proper consideration of menopausal status. Many women walk away from consultations confused and without a clear plan, perpetuating suffering and misunderstanding.

Tamsen emphasizes that healthcare providers across all specialties—not solely OBGYNs—should be knowledgeable about menopause, as its effects span cardiovascular, neurological, and bone health domains. She advocates for systemic change in medical education and research funding to address this critical gap.

Managing Menopause: Options and Strategies

Tamsen outlines practical approaches for women navigating this transition, emphasizing that there is no one-size-fits-all solution. Lifestyle modifications serve as a foundational method, focusing on improving sleep quality, increasing protein intake, engaging in strength training for bone health, managing inflammation through diet, and prioritizing stress management. She highlights that quality sleep is arguably the paramount priority to help manage symptoms effectively.

Hormone therapy (HT), or menopausal hormone therapy, is presented as one of the most effective treatments for symptoms like hot flashes and vaginal dryness. Despite the public scare following the 2002 Women's Health Initiative study headlines, which drastically reduced HT usage, current understanding recognizes HT as a viable, safe option for many women when appropriately managed. HT usually consists of estrogen, progesterone, and sometimes testosterone or localized vaginal estrogen to target specific symptoms.

Tamsen candidly shares her own journey with HT, describing it as a pivotal choice that restored her quality of life. However, she stresses that women must be individually assessed for eligibility due to some risk factors, underscoring the importance of informed medical guidance.

Community and emotional support form another crucial pillar. Women benefit immeasurably from connecting with others undergoing similar experiences, sharing knowledge, and breaking the sense of isolation. Tamsen sees this sense of community as distinct from friendship because it involves shared experience and understanding.

The Role of Men in Supporting Women

An important dimension of the episode is the role men can play in supporting women through menopause. Jay reflects on the multiple women in his life who will or have experienced menopause, expressing a desire to understand and support them better.

Tamsen encourages men to educate themselves on the basics of menopause and perimenopause symptoms, emphasizing the importance of patience, presence, and communication rather than trying to "fix" everything. Simple acts like acknowledging symptoms, adjusting daily routines together, and empathetic listening can profoundly help women feel seen and supported.

She recounts a story of a man attending her book signing who wanted to give her book to his daughters and their husbands to increase awareness and dialogue—highlighting the power of knowledge to change cultural narratives.

Looking Ahead

In closing, Tamsen reflects on how menopause gave her newfound purpose, transforming a once-feared and misunderstood journey into a mission to educate and empower others. She envisions a future where menopause and perimenopause are openly discussed in schools, medical offices, and homes, supported by rigorous research and compassionate healthcare.

Her message is clear and hopeful: menopause is not an end, nor a disease, but a natural transition—one that women can navigate with knowledge, support, and care to feel "even better than before." By breaking the taboos, investing in research and training, and fostering community, society can finally give menopause the respect and attention it deserves.